Setting
The setting for the study was a medium sized terti-ary care hospital located in the southwestern United States. The course was implemented within the care facility’s Simulation Center, a 3300 square foot facility with a 20-seat classroom and four simulation environ-ments – an operating room, an intensive care/emergency department room, a medical-surgical hospi-tal room, and an outpatient room. The simulation rooms are built around a core control room used by the staff to run and record simulation activities. All clinical scenarios for this study were scheduled in the medical-surgical environment which is designed to be similar to a standard hospital room. The Simulation Center pro-vided a SimMan 3G® human patient simulator for the clinical scenarios as well as the necessary clinical equipment. All simulations are recorded using a web-based system for capturing, annotating and archiving videos obtained during scenarios and debriefing. This system also allows students who are not direct partici-pants the scenario an opportunity to observe the sce-nario in real time. This capability permits observers to consider their own approaches to the situation and par-ticipate in the debriefing.